Gemcitabine and docetaxel for the treatment of children and adolescents with recurrent or refractory osteosarcoma: Korea Cancer Center Hospital experience

Background We evaluated the efficacy of gemcitabine and docetaxel chemotherapy (GEM+DOC) in children and adolescents with recurrent or refractory osteosarcoma. Methods Data of 28 patients (20 male, 8 female) who received gemcitabine (675 or 900mg/m2 on days 1 and 8) and docetaxel (100mg/m2 on day 8) at Korea Cancer Center Hospital were retrospectively reviewed. Results Patients (ages 5.0-19.7 years) received a total of 96 courses of chemotherapy (median 3 courses; range, 1-8 courses) and were followed for a median of 14.9 months (range, 0.6-81.4 months). Eleven patients received GEM+DOC after surgery as adjuvant chemotherapy. Seventeen patients received GEM+DOC as palliative therapy, and were eligible for response evaluation; there were three (17.6%) complete response (CR, including two metabolic CR), one (5.9%) partial responses (PR), and three (29.4%) stable disease (SD). The objective response rate (CR+PR) and tumor control rate (CR+PR+SD) were 23.5% and 41.2%, respectively. The median duration of response was 11.2 months (range, 2.8-14.6 months). Dose of gemcitabine (675 or 900mg/m2) did not influence the response rate. Overall survival at 1-year was 53.6 +/- 9.4% and patients who received GEM+DOC as adjuvant chemotherapy fared better than those who received GEM+DOC as palliative therapy (72.7 +/- 13.4% vs. 35.3 +/- 11.6%, P=0.006). Conclusion GEM+DOC showed some activity in osteosarcoma. Better than expected survival after GEM+DOC was seen both in patients with and without surgery. These results may indicate that dose dense combinations of gemcitabine and taxanes (e.g., gemcitabine+nab-paclitaxel) should be investigated in bone sarcomas. Pediatr Blood Cancer 2014; 61:1376-1381. (c) 2014 Wiley Periodicals, Inc.